Microwave ablation of synovial hypertrophy in recurrent monoarthritis: the results of extended cohort and long-term follow-up
Rheumatology, cilt.64, sa.4, ss.1651-1660, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 64 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.1093/rheumatology/keae348
- Dergi Adı: Rheumatology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1651-1660
- Anahtar Kelimeler: microwave ablation, recurrent monoarthritis, treatment resistance, synovial hypertrophy, synovectomy, musculoskeletal radiology
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: Recurrent monoarthritis (RM) is a major challenge of many rheumatic diseases. Ablation is a well-known technique in the treatment of benign or malign lesions of different aetiologies. We aimed to investigate the success and safety of microwave ablation (MWA) as an adjunctive therapy in a cohort of medical treatment-resistant RM. Methods: Patients with RM associated with different inflammatory diseases were included. MWA was performed after measuring the size of synovial hypertrophy with 15 or 20 W power and different durations until microbubbles were shown, indicating necrosis. Both clinical and radiologic data were recorded. Results: We applied MWA in total of 24 knee joints of 10 female and 12 male patients aged between 22 and 71 years. Median IA aspiration (IAA) need in the last 6 months before MWA was 5 (0–15). The median follow-up was 10 (3–16) months. Overall IAA count in the last 6 months before MWA in total of 144 months was 129, and decreased to 7 in post-MWA in total of 226 months (0.89 vs 0.03 per month, P < 0.001). The second MWA session was needed for three patients and a third session for one. Functional disability and pain scores were improved significantly (median score from 9 to 1, P < 0.00001, in both). In MRI, follow-up significant regression in synovial hypertrophy size was shown especially after the 6th month. No complication was observed during the procedure or follow-up. Conclusion: As a less invasive technique compared with the surgical approach, MWA of synovial hypertrophy showed significant clinical improvement in RM safely. MWA seems promising as a treatment option candidate in the management of RM.